Episiotomies aren’t exactly easy peasy, despite being one of the most commonly performed procedures worldwide. What seems like a good idea at the time can lead to a world of pain, with the potential for consequential trauma to the perineum, all the way through to the anus and back again.
With 90% of women experiencing tears down there during childbirth, this surgical cut to the perineum offers an alternative to uncontrolled tearing. But, is education surrounding the procedure a common approach? Do we understand enough about the potential impact of cutting ‘down there’ before writing it off as an easy recovery?
Episiotomy education is essential prenatal learning, but in many cases, is sorely lacking
What really happens ‘down there’?
Research and clinical trials involving episiotomy processes reveal a women’s preference or view on the procedure is inadequately considered in the heat of labour. Even seeking consent before cutting away, shockingly isn't the norm. Recovery can be slow and uncomfortable, as the raw, fleshy wound sits perfectly in the way of any lounging or feeding positions you might try in your new postnatal body. For some;
- Infection is possible
- Ongoing pain at the site is considered normal
- Urinary incontinence can be a thing
- Mobility and movement can be significantly compromised
- The wound can continue to cause pain during sex for months on end
One particular episiotomy incision- ‘the midline’- can lead to fourth degree tearing, with fecal incontinence a possible complication. No, no, no. No-one mentioned this in the lead up.
Perineal prep, stretch + recovery
We know a lot about preparing the perineum for birth. Massaging the area in the lead up to the end of pregnancy can reduce the risk of perineal trauma. Warm compresses are widely recommended during labour to increase comfort. Even the position you push in, can make or break your vagina. Literally. On the postpartum side, studies have shown supplementing with bromelain enzymes can significantly reduce associated inflammation, swelling, bruising and pain, hastening the time it takes to heal.
Episiotomy education is essential prenatal learning, but in many cases, is sorely lacking. With a culture of focusing on baby’s health in all pre birth health sessions, and glossing over the healing process on the other side, it’s more important than ever for women to speak up.
- Ask about episiotomies, tearing, stretching and recovery in the lead up to birth.
- Share experiences in the aftermath.
- Ask if your recovery process is ‘normal’ or just common.
We need to know it all. The good, the bad, and the ugly.